Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

Abstract

The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11) had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA) was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

Dental Splints: Types and Time of Immobilization Post Tooth Avulsion

“…Mineral trioxide aggregate (MTA) was placed at the entrance of the root canal and the crown was restored. In both cases, it was possible to notice periapical repair and apical closure ( 31 , 32 ).…”

“…The same approach was also described by Lucisano at al. in the follow year to manage a similar case ( 32 ): in both cases a 8-year old boy had his teeth replanted after 30min and 1 day of avulsion, respectively. Besides dental splint, revascularization therapy was performed by irrigating the root canal and applying a calcium hydroxide paste and 2% chlorhexidine gel for 21 days.…”